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Kosuke Takahashi, Yuki Morizane, Shuhei Kimura, Mio Hosokawa, Yusuke Shiode, Masayuki Hirano, Shinichiro Doi, Shinji Toshima, Mika Hosogi, Yuki Kanzaki, Atsushi Fujiwara, Ippei Takasu, Fumio Shiraga; Long-term outcomes of lamellar macular hole surgery using LHEP. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5914.
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© ARVO (1962-2015); The Authors (2016-present)
Recently, we have reported the short-term results of modified vitrectomy using lamellar hole-associated epiretinal proliferation (LHEP) for the treatment of degenerative lamellar macula hole (LMH, Shiraga et al. Retina 2013). Although the technique was effective for improving visual acuity and retinal structure, it’s long-term effectiveness is unknown. Therefore, we investigated the long-term outcomes of this technique for degenerative LMH.
We retrospectively reviewed the medical records of 34 consecutive eyes of 34 LMH patients who had LHEP and underwent vitrectomy from January 2010 to March 2016. After vitrectomy, LHEP was peeled centripetally and embedded into the retinal cleavage. After peeling the internal limiting membrane, fluid-SF6 gas (20%) exchange was performed before finishing the surgery. Patients maintained facedown position for 24 hours. All patients who had cataract underwent lens reconstruction.
The mean follow-up period (±SD) was 30.0±17.7 months. Twelve patients (35%) were men, and the mean age of the patient group was 69.6±10.1 years. Twenty-three eyes (68%) underwent simultaneous cataract surgery. The mean best corrected visual acuity (BCVA) and the mean central retinal thickness (CRT) before vitrectomy was 0.31±0.25 and 123.2±42.6 μm, respectively. These both improved significantly at the final visit (0.10±0.25 and 191.2±45.3 μm, respectively; P<0.001 for both results). Defects in the external limiting membrane and the ellipsoid zone were detected before surgery in 17 eyes (50%) and 15 eyes (44%), respectively, but were only detected in 7 eyes (21%) and 8 eyes (24%) at the final visit, respectively. No intraoperative or postoperative complications, such as development of full thickness macular hole or recurrence of LMH or LHEP, were observed.
In long-term, vitrectomy using LHEP was safe and effective in improving visual acuity and retinal structure of degenerative LMH.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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